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Duration and characteristics of persistent headache following aneurysmal subarachnoid hemorrhage

Duration and characteristics of persistent headache following aneurysmal subarachnoid hemorrhage
Duration and characteristics of persistent headache following aneurysmal subarachnoid hemorrhage
Objective: to assess the long-term frequency, prognosis, and phenotype of persistent headache following aneurysmal subarachnoid hemorrhage (aSAH).

Background: very little is known about long-term headache following aSAH with no studies looking beyond 3 years.

Methods: retrospective analysis comparing aSAH cases to matched controls in the UK Biobank, a prospective cohort study. Headache frequency and phenotype were compared using group comparison tests. The relationship between headache fre-quency and time was assessed using correlation analysis.

Results: headache was more frequent following aSAH (aSAH: 258/864 [29.9%] vs. controls: 666/3456 [19.3%], χ2= 45.5, p< 0.001) at a median follow-up of 7.5 years. Headache frequency decreased over time (RS= −0.71, p= 0.028), affecting 29/58 (50%) patients in the first year and reducing to 13/47 (28%) patients 10 years later. Headache frequency was not related to aSAH severity (z= 0.249, p= 0.803), treat-ment (z= 0.583, p= 0.560), or hydrocephalus (z= −1.244, p= 0.214). There was a consistently higher frequency of migrainous features following aSAH compared to controls, although this did not reach statistical significance.

Conclusions: persistent headache is more frequent following aSAH compared to con-trols in the long term and the prevalence reduces gradually over time. The increased frequency of migrainous features suggests that selected patients with post-aSAH headache may benefit from migraine treatment.
headache, migraine, outcome, subarachnoid hemorrhage
1526-4610
1376-1382
Gaastra, Ben
c7b7f371-706b-4d59-9150-94e8f254e205
Carmichael, Harry
46780173-28a7-4490-8438-2d402f7d21f8
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d
Gaastra, Ben
c7b7f371-706b-4d59-9150-94e8f254e205
Carmichael, Harry
46780173-28a7-4490-8438-2d402f7d21f8
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Bulters, Diederik
d6f9644a-a32f-45d8-b5ed-be54486ec21d

Gaastra, Ben, Carmichael, Harry, Galea, Ian and Bulters, Diederik (2022) Duration and characteristics of persistent headache following aneurysmal subarachnoid hemorrhage. Headache, 62 (10), 1376-1382. (doi:10.1111/head.14418).

Record type: Article

Abstract

Objective: to assess the long-term frequency, prognosis, and phenotype of persistent headache following aneurysmal subarachnoid hemorrhage (aSAH).

Background: very little is known about long-term headache following aSAH with no studies looking beyond 3 years.

Methods: retrospective analysis comparing aSAH cases to matched controls in the UK Biobank, a prospective cohort study. Headache frequency and phenotype were compared using group comparison tests. The relationship between headache fre-quency and time was assessed using correlation analysis.

Results: headache was more frequent following aSAH (aSAH: 258/864 [29.9%] vs. controls: 666/3456 [19.3%], χ2= 45.5, p< 0.001) at a median follow-up of 7.5 years. Headache frequency decreased over time (RS= −0.71, p= 0.028), affecting 29/58 (50%) patients in the first year and reducing to 13/47 (28%) patients 10 years later. Headache frequency was not related to aSAH severity (z= 0.249, p= 0.803), treat-ment (z= 0.583, p= 0.560), or hydrocephalus (z= −1.244, p= 0.214). There was a consistently higher frequency of migrainous features following aSAH compared to controls, although this did not reach statistical significance.

Conclusions: persistent headache is more frequent following aSAH compared to con-trols in the long term and the prevalence reduces gradually over time. The increased frequency of migrainous features suggests that selected patients with post-aSAH headache may benefit from migraine treatment.

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Published date: 25 November 2022
Additional Information: Funding Information: The authors acknowledge the use of the IRIDIS High Performance Computing Facility, and associated support services at the University of Southampton, in the completion of this work. This research has been conducted using the UK Biobank Resource under Aplication Number 49305. Funding Information: BG is funded by the Royal College of Surgeons, Society of British Neurological Surgeons, Barrow Foundation, and Guarantors of Brain in addition to the Institute for Life Sciences, University of Southampton. Publisher Copyright: © 2022 The Authors. Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.
Keywords: headache, migraine, outcome, subarachnoid hemorrhage

Identifiers

Local EPrints ID: 472900
URI: http://eprints.soton.ac.uk/id/eprint/472900
ISSN: 1526-4610
PURE UUID: 69d6b477-bbc4-4595-b742-df88895594d2
ORCID for Ben Gaastra: ORCID iD orcid.org/0000-0002-7517-6882
ORCID for Ian Galea: ORCID iD orcid.org/0000-0002-1268-5102
ORCID for Diederik Bulters: ORCID iD orcid.org/0000-0001-9884-9050

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Date deposited: 05 Jan 2023 18:01
Last modified: 17 Mar 2024 04:07

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Contributors

Author: Ben Gaastra ORCID iD
Author: Harry Carmichael
Author: Ian Galea ORCID iD
Author: Diederik Bulters ORCID iD

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